ObjectiveTo explore the molecular mechanisms by which serum containing Gegen Qinlian Tang （GQT） inhibits glycolysis and enhances chemotherapy sensitivity in 5-fluorouracil （5-FU）-resistant colorectal cancer （CRC） cells based on the cyclin-dependent kinase 16 （CDK16）/MYC proto-oncogene （MYC） pathway. MethodsHCT-116/5-FU cells were treated with different concentrations （5%， 10%， 20%， 30%） of GQT-containing serum. Cell viability and 5-FU sensitivity were assessed using the cell counting kit-8 （CCK-8） assay， and the experimental concentrations of 5-FU and GQT for subsequent experiments were determined. Cell proliferation and apoptosis under individual 5-FU， GQT， and combined 5-FU + GQT treatments were evaluated using 5-ethynyl-2′-deoxyuridine （EDU） staining and annexin V-FITC/PI double staining， respectively. Glucose consumption， adenosine triphosphate （ATP） production， and lactate levels were measured by colorimetric assays. Expression levels of glycolysis-related proteins， CDK16， MYC， and phosphorylated MYC were detected by Western blot. Co-immunoprecipitation （CoIP） was used to examine the protein interaction between CDK16 and MYC， and cycloheximide （CHX） treatment was applied to assess the effect of CDK16 overexpression on MYC protein stability. ResultsCCK-8 assays showed that 2.5 mg·L^-1 5-FU significantly inhibited HCT-116 cell viability in a dose-dependent manner. In HCT-116/5-FU cells， significant inhibition was observed only at 5 mg·L^-1 5-FU （P<0.05）， which was used for model establishment. Compared with 5-FU alone， addition of 5% GQT-containing serum significantly suppressed HCT-116/5-FU cell viability （P<0.05）， with stronger inhibition at higher serum concentrations. Thus， 5% GQT-containing serum was used in subsequent experiments. Compared with the control group， 5-FU， GQT， and 5-FU + GQT treatments all significantly reduced cell proliferation （P<0.05） and increased apoptosis （P<0.01）. The 5-FU + GQT combination showed superior inhibition of proliferation compared with 5-FU or GQT alone （P<0.01）， accompanied by more pronounced reductions in glucose consumption， ATP production， and lactate generation （P<0.01）. Additionally， compared with control， 5-FU， and GQT groups， the 5-FU + GQT group exhibited stronger suppression of MYC and its phosphorylated forms （P<0.01） and greater inhibition of glycolytic enzymes， including hexokinase 2 （HK2）， 3-phosphoinositide-dependent protein kinase 1 （PDK1）， lactate dehydrogenase A （LDHA）， and pyruvate kinase M2 （PKM2） （P<0.01）. CDK16， MYC， and MYC phosphorylation expression levels were significantly downregulated in the 5-FU + GQT group compared with the 5-FU group （all P<0.01）. MYC protein stability decreased in a time-dependent manner in the 5-FU + GQT group （P<0.05）， which was rescued by CDK16 overexpression （P<0.05）. ConclusionGQT significantly enhances the sensitivity of HCT-116/5-FU cells to 5-FU， potentially by inhibiting CDK16 and thereby reducing MYC-mediated glycolysis.

ObjectiveTo explore the molecular mechanisms by which serum containing Gegen Qinlian Tang （GQT） inhibits glycolysis and enhances chemotherapy sensitivity in 5-fluorouracil （5-FU）-resistant colorectal cancer （CRC） cells based on the cyclin-dependent kinase 16 （CDK16）/MYC proto-oncogene （MYC） pathway. MethodsHCT-116/5-FU cells were treated with different concentrations （5%， 10%， 20%， 30%） of GQT-containing serum. Cell viability and 5-FU sensitivity were assessed using the cell counting kit-8 （CCK-8） assay， and the experimental concentrations of 5-FU and GQT for subsequent experiments were determined. Cell proliferation and apoptosis under individual 5-FU， GQT， and combined 5-FU + GQT treatments were evaluated using 5-ethynyl-2′-deoxyuridine （EDU） staining and annexin V-FITC/PI double staining， respectively. Glucose consumption， adenosine triphosphate （ATP） production， and lactate levels were measured by colorimetric assays. Expression levels of glycolysis-related proteins， CDK16， MYC， and phosphorylated MYC were detected by Western blot. Co-immunoprecipitation （CoIP） was used to examine the protein interaction between CDK16 and MYC， and cycloheximide （CHX） treatment was applied to assess the effect of CDK16 overexpression on MYC protein stability. ResultsCCK-8 assays showed that 2.5 mg·L^-1 5-FU significantly inhibited HCT-116 cell viability in a dose-dependent manner. In HCT-116/5-FU cells， significant inhibition was observed only at 5 mg·L^-1 5-FU （P<0.05）， which was used for model establishment. Compared with 5-FU alone， addition of 5% GQT-containing serum significantly suppressed HCT-116/5-FU cell viability （P<0.05）， with stronger inhibition at higher serum concentrations. Thus， 5% GQT-containing serum was used in subsequent experiments. Compared with the control group， 5-FU， GQT， and 5-FU + GQT treatments all significantly reduced cell proliferation （P<0.05） and increased apoptosis （P<0.01）. The 5-FU + GQT combination showed superior inhibition of proliferation compared with 5-FU or GQT alone （P<0.01）， accompanied by more pronounced reductions in glucose consumption， ATP production， and lactate generation （P<0.01）. Additionally， compared with control， 5-FU， and GQT groups， the 5-FU + GQT group exhibited stronger suppression of MYC and its phosphorylated forms （P<0.01） and greater inhibition of glycolytic enzymes， including hexokinase 2 （HK2）， 3-phosphoinositide-dependent protein kinase 1 （PDK1）， lactate dehydrogenase A （LDHA）， and pyruvate kinase M2 （PKM2） （P<0.01）. CDK16， MYC， and MYC phosphorylation expression levels were significantly downregulated in the 5-FU + GQT group compared with the 5-FU group （all P<0.01）. MYC protein stability decreased in a time-dependent manner in the 5-FU + GQT group （P<0.05）， which was rescued by CDK16 overexpression （P<0.05）. ConclusionGQT significantly enhances the sensitivity of HCT-116/5-FU cells to 5-FU， potentially by inhibiting CDK16 and thereby reducing MYC-mediated glycolysis.

ObjectiveTo investigate the main risk factors for liver cirrhosis in chronic hepatitis B （CHB） patients with high metabolic risk， to establish a noninvasive predictive model， and to compare the diagnostic efficiency of this model and other models including fibrosis-4 （FIB-4）， aspartate aminotransferase-to-platelet ratio index （APRI）， gamma-glutamyl transpeptidase-to-platelet ratio （GPR）， and Forns index. MethodsA total of 527 CHB patients with high metabolic risks who were admitted to The Second Affiliated Hospital of Guangxi Medical University from September 1， 2017 to October 31， 2022 were enrolled as subjects， and they were randomly divided into modeling group with 368 patients and validation group with 159 patients at a ratio of 7∶3. The LASSO regression analysis and the multivariate Logistic regression analysis were performed for the modeling group to identify independent risk factors， and a nomogram model was established. The receiver operating characteristic （ROC） curve， the calibration curve， and the decision curve analysis were used to validate the nomogram prediction model in the modeling group and the validation group and assess its discriminatory ability， calibration， and clinical practicability. The Delong test was used to compare the area under the ROC curve （AUC） of the nomogram prediction model and other models. ResultsThe multivariate Logistic regression analysis showed that prealbumin （odds ratio ［OR］ = 0.993， 95% confidence interval ［CI］： 0.988 — 0.999， P= 0.019）， thrombin time （OR=1.182， 95% CI： 1.006 — 1.385， P=0.047）， log₁₀ total bilirubin （TBil） （OR=1.710， 95%CI： 1.239 — 2.419， P=0.001）， and log₁₀ alpha-fetoprotein （AFP） （OR=1.327， 95%CI： 1.052 — 1.683， P=0.018） were independent influencing factors for liver cirrhosis in CHB patients with high metabolic risks. A nomogram model for risk prediction was established based on the multivariate analysis， which had an AUC of 0.837 （95%CI： 0.788 — 0.888）， a specificity of 73.5%， and a sensitivity of 84.7%， as well as a significantly higher diagnostic efficiency than the models of FIB-4 （0.739）， APRI （0.802）， GPR （0.800）， and Forns index （0.709） （Z=2.815， 2.271， 1.989， and 2.722， P=0.005， 0.017， 0.045， and 0.006）. ConclusionThe nomogram model established based on prealbumin， thrombin time， log₁₀ TBil， and log₁₀ AFP has a certain clinical application value.

Drug-induced liver injury is caused by the drug itself and/or its metabolites during drug use or occurs due to hypersensitivity or reduced tolerance to the drug in a particular body type. In the last three years of the diagnosis and treatment of coronavirus disease 2019 （COVID-19）， antiviral drugs have played a very important role， but there are many reports on liver injury caused by anti-COVID-19 drugs in China and globally， with unknown pathogenesis of liver injury caused by such drugs. This article reviews the research advances in the types of antiviral drugs for COVID-19 and their mechanism in inducing liver injury， in order to promote the rational use of antiviral drugs.

Objective:To observe the clinical efficacy of Yin-Yang balancing acupuncture plus Tuina(Chinese therapeutic massage)for post-stroke depression(PSD). Methods:A total of 72 PSD patients were randomized into an acupuncture-Tuina group and a Western medicine group using the random number table method,with 36 cases in each group.The Western medicine group was treated with fluoxetine hydrochloride capsules.The acupuncture-Tuina group was treated with Yin-Yang balancing acupuncture plus Tuina therapy.Both groups were treated for 4 weeks.After treatment,the clinical efficacy was compared,and the changes in Hamilton depression scale(HAMD)score,National Institute of Health stroke scale(NIHSS)score,serum neurotransmitter levels,and electroencephalogram(EEG)were observed. Results:The total effective rate of the Western medicine group and the acupuncture-Tuina group was 83.3%and 94.4%,respectively.There was a significant difference in the total effective rate between the two groups(P<0.05).After treatment,the serum levels of 5-hydroxytryptamine(5-HT),norepinephrine(NE),and dopamine(DA)were higher than those in the same group before treatment,and the intra-group differences were all statistically significant(P<0.05).The serum levels of 5-HT,NE,and DA in the acupuncture-Tuina group were higher than those in the Western medicine group,and the differences between the groups were statistically significant(P<0.05).After treatment,the scores of HAMD and NIHSS in both groups decreased,and the intra-group differences were statistically significant(P<0.05).The scores in the acupuncture-Tuina group were lower than those in the Western medicine group,and the differences between the two groups were all statistically significant(P<0.05).After treatment,the EEG diffuse wave[(delta+theta)/(alpha+beta)]ratio(DTABR)and delta/beta ratio(DBR)in both groups decreased,and the intra-group differences were statistically significant(P<0.05).The ratios in the acupuncture-Tuina group were lower than those in the Western medicine group,and the differences between the two groups were statistically significant(P<0.05). Conclusion:Yin-Yang balancing acupuncture plus Tuina therapy has a better efficacy than oral fluoxetine hydrochloride capsules in the treatment of PSD,which can increase the levels of serum 5-HT,DA,and NE,and regulate brain waves.

Objective:To evaluate the clinical efficacy of acupuncture in the treatment of anxiety state in patients with primary insomnia(PI). Methods:Randomized controlled trials of acupuncture treatment for PI patients with an anxiety state in Web of Science,Cochrane Library,PubMed,Excerpta Medica Database(EMBASE),China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform(Wanfang),and Chongqing VIP Database(VIP)were retrieved by computer.The retrieval time was from each database's inception to December 30,2022.Data extraction and evaluation were performed for the included studies.The Cochrane risk of bias assessment tool was used to assess the risk of bias in each article.Meta-analysis of valid data was performed using the RevMan 5.4 software.If the outcome indicator was a categorical variable,relative risk(RR)was used as the effect size.If it was a continuous variable,mean difference(MD)was used to calculate the effect size.Each effect size was expressed as a 95%confidence interval(CI).P<0.05 was considered to indicate a statistically significant difference. Results:A total of 18 studies were included,comprising a total of 1198 patients.The findings of the meta-analysis showed that electroacupuncture had a significant advantage in improving the Hamilton anxiety scale(HAMA)score than benzodiazepines[MD=-1.61,95%CI(-2.17,-1.06),P<0.001].Acupuncture was superior to sham acupuncture[MD=-14.90,95%CI(-20.39,-9.41),P<0.001]and benzodiazepines[MD=-3.39,95%CI(-4.67,-2.12),P<0.001]in reducing the self-rating anxiety scale(SAS)score.Acupuncture was superior to sham acupuncture in reducing the insomnia severity index(ISI)score[MD=-5.61,95%CI(-6.63,-4.89),P<0.001].Acupuncture was superior to benzodiazepines[MD=0.84,95%CI(-1.42,-0.25),P=0.005]and sham acupuncture[MD=-8.39,95%CI(-8.39,-7.86),P<0.001]in improving the Pittsburgh sleep quality index(PSQI)score.Acupuncture had a better effective rate than benzodiazepines[RR=1.16,95%CI(1.08,1.25),P<0.001]and sham acupuncture[RR=8.94,95%CI(4.63,17.25),P<0.001]in treating PI. Conclusion:Acupuncture or electroacupuncture has certain therapeutic advantages over benzodiazepines and sham acupuncture in the treatment of anxiety in PI patients.However,more high-quality randomized controlled trials are needed for further verification.

Objective:To observe the clinical efficacy of back-Shu and front-Mu points combination needling on balance and walking function in patients after stroke and its mechanism. Methods:A total of 79 patients with post-stroke balance and walking dysfunction were randomly divided into a control group and an observation group.Both groups received conventional treatments such as dietary guidance and oral medications as well as rehabilitation training.On this basis,the control group was treated with additional conventional acupuncture,and the observation group was treated with additional back-Shu and front-Mu points combination needling.Both groups were treated for 4 consecutive weeks.The thickness of abdominal muscle group(transverse abdominal muscle,rectus abdominis,obliquus internus abdominis,and obliquus externus abdominis),the scores of Berg balance scale(BBS),Fugl-Meyer assessment(FMA),and functional ambulation categories(FAC),and walking velocity and stride were compared between the two groups. Results:During the trial,there was 1 dropout case in the control group and 4 dropout cases in the observation group.Before treatment,there were no statistical differences in the abdominal muscle group thickness,scores of BBS,FMA,and FAC,and walking velocity and stride between the two groups(P>0.05).After 4 weeks of treatment,the thickness of abdominal muscle groups,scores of BBS,FMA,and FAC,and walking velocity and stride in both groups were improved(P<0.01),and the observation group was superior to the control group(P<0.05). Conclusion:Both conventional acupuncture and back-Shu and front-Mu points combination needling are conducive to the improvement of balance and walking function in patients after stroke.The back-Shu and front-Mu points combination needling method has better curative efficacy.Strengthening the core muscle group strength may be one of the mechanisms of back-Shu and front-Mu points combination needling treatment.

Objective To investigate the effect of adjuvant therapy of Shenfu Injection on NOD-like receptor protein 3 (NLRP3)/cysteine-aspartic acid-specific protease 1 (Caspase-1) mediated pyroptosis signaling pathway and inflammatory factor levels in rats with acute myocardial infarction (AMI). Methods A total of 40 rats were randomly divided into sham operation group, model group, betaloc group (0.9 mg/kg), and combination group (0.9 mg/kg betaloc combined with 6 mL/kg Shenfu Injection), with 10 rats in each group. The rats were treated by gavage continuously for 3 weeks. The levels of serum troponin I (cTnI), creatine kinase-MB (CK-MB), interleukin (IL)-6, IL-1β, and tumor necrosis factor-α (TNF-α) in rats were detected before modeling, after modeling, and at 3 weeks of treatment. Echocardiographic parameters such as left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter(LVESD), left ventricular end-diastolic diameter (LVEDD), and myocardial infarction area were compared among groups after modeling and at 3 weeks of treatment. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) and Western blot were used to detect the mRNA and protein expression levels of NLRP3 and Caspase-1 in the myocardium. Results Compared with the sham operation group, the levels of cTnI, CK-MB, IL-6, IL-1β, TNF-α, myocardial infarction area, and the expressions of NLRP3 mRNA and Caspase-1 mRNA in the model group were significantly increased after modeling and at 3 weeks of treatment (P < 0.05); compared with the model group, the levels of cTnI, CK-MB, IL-6, IL-1β, TNF-α, myocardial infarction area, and the expressions of NLRP3 mRNA and Caspase-1 mRNA in the betaloc group and the combination group were significantly decreased at 3 weeks of treatment, and the above indicators in the combination group were significantly lower than those in the betaloc group (P < 0.05). Conclusion Adjuvant therapy of Shenfu Injection for AMI can further alleviate myocardial cell injury, shorten infarction size, and inhibit inflammatory response and pyroptosis activity.

【Objective】 To analyze the efficacy and safety of intralesional triamcinolone acetonide in the treatment of mass granulomatous mastitis (GLM). 【Methods】 Retrospective analysis was made on 67 patients with GLM who were treated in Xijing Hospital from July 2021 to May 2022 and met the inclusion criteria. Among them, 31 patients were treated with local injection of triamcinolone acetonide, while 36 ones were treated with oral methylprednisolone. All the included patients underwent surgical treatment after their condition met the surgical criteria, and the follow-up period lasted for up to six months after surgery. The two groups were compared in improvement of symptoms and signs, treatment time, clinical effectiveness and safety, and recurrence rate. 【Results】 The effective rate of triamcinolone acetonide group and methylprednisolone group was 100%, but the clinical cure rate was significantly higher in triamcinolone acetonide group than in methylprednisolone group in stratified analysis (P<0.05). The improvement time of symptoms and signs in triamcinolone acetonide group was significantly shorter than that in methylprednisolone group (P<0.05). The incidence of side effects in triamcinolone acetonide group was also significantly reduced compared to methylprednisolone group (P<0.05). Follow-up for half a year showed no recurrence in both groups. 【Conclusion】 Compared with the traditional oral methylprednisolone group, local injection of triamcinolone acetonide in the treatment of mass granulomatous mastitis can rapidly relieve clinical symptoms and signs, shorten treatment time, and has higher efficiency and fewer side effects. Local injection of hormone combined with surgery is effective in treating mass granulomatous mastitis with low recurrence rate.

Objective:To observe the effect of combined acupuncture and medication on hyperarousal state and serum copeptin(CPT)in patients with chronic insomnia(CI),and to explore its possible mechanism of action.Methods:A total of 70 CI patients meeting the inclusion criteria were divided into an observation group and a control group by the random number table method,with 35 cases in each group.The control group was given estazolam tablets before bedtime,1 mg/time,once a day.The observation group was treated with additional Yi Nao An Shen acupuncture therapy(acupuncture for benefiting the brain and tranquillization)on the basis of the medication treatment,4 times a week.After 4 weeks of treatment,the Pittsburgh sleep quality index(PSQI)score,insomnia severity index(ISI)score,pre-sleep arousal scale(PSAS)score,hyperarousal scale(HAS)score,and the change in serum CPT level were compared between the two groups.Results:During the study,there were 2 dropout cases in the observation group and 1 dropout case in the control group.After treatment,the PSQI,ISI,PSAS,and HAS scores and the serum CPT level in both groups decreased compared with the same group before treatment,and the intra-group differences were statistically significant(P<0.05).After treatment,changes in each above scale score and the serum CPT level in the observation group were much more significant and were statistically different from those in the control group(P<0.05).Conclusion:Acupuncture plus medication can improve sleep quality,reduce the degree of insomnia,and regulate hyperarousal state in patients with CI,and its mechanism of action may be related to the down-regulation of serum CPT level.